CRC Practice Exam A with 100%
Correct Answers
Which of the following medications are prescribed to cancer patients to eradicate the
cancer or for prophylaxis?
I. Tamoxifen
II. Anastrozole
III. Januvia
IV. Crestor
A. I and II
B. I and III
C. II and III
D. I, II, III and IV - ANSWER-A
Anastrozole is used to treat breast cancer in women who have gone through
menopause. It works by lowering estrogen hormone levels to help shrink tumors and
slow their growth. Tamoxifen is prescribed for women who have breast cancer with
tumors fueled by estrogen. The medication blocks the action of estrogen.
The definition of a best medical record for a RADV audit is:
A. Documentation validates the CMS requested HCCs, contains all the necessary
documentation elements and has an additional HCC not requested by CMS
B. Documentation that validates all the requested HCCs
C. Documentation that validates the requested HCC, but there is no provider signature
D. Documentation that validates the requested HCC plus validates an additional HCC,
contains all the necessary documentation elements, but is missing the provider
signature, for which a signed CMS attestation was provided but not signed by the
provider - ANSWER-A
RADV guidelines state that the Best Medical Record contains documentation that
supports HCC and all elements of proper documentation are followed, for example,
signed by provider. Proper documentation is the first aspect that must be reviewed to
determine if the record could be considered a Best Medical Record. After proper
documentation is determined, the additional HCC (which can decrease the amount
owed to CMS) within the note makes this the Best Medical Record.
Which of the following are reported by a provider for beneficiaries in a Medicare
Advantage Plan?
I. Nature of the presenting problem
II. Resolved conditions that have been treated in the past
III. Family history for all conditions
IV. All chronic conditions
A. I
, B. II and III
C. I and IV
D. I, II, III and IV - ANSWER-C
Providers must report all diagnoses that affect the patient's evaluation, care, and
treatment, including: Nature of the presenting problem All chronic conditions (such as
atrial fibrillation, congestive heart failure (CHF), chronic kidney disease (CKD),
rheumatoid arthritis, diabetes with manifestations, chronic obstruction pulmonary
disease (COPD), all active cancers) History on any relevant past conditions ZV-codes
(factors that influence health/status codes) E-codes (external causes of injury and
poisoning, and certain other consequences of external causes) HCC scores on
individual members determine CMS reimbursement to the plan. Diagnosis and
demographic information should be captured at each face-to-face encounter to obtain a
health-based measure of that member's future medical needs.
Which of the following records would be a good source for a retrospective chart audit?
A. DME documentation
B. Cardiologist records
C. Dietician notes
D. RN notes - ANSWER-B
A cardiologist is the only approved provider provided as an answer option according to
CMS for Risk Adjustment
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS
A. I
B. II
C. I and II
D. I, II and III - ANSWER-D
What is/are the correct code(s) for a nursing home patient with severe dementia often
caught wandering off from the floor?
A. F03.91, Z91.83
B. F02.81, Z91.83
C. F03.90, Z91.83
D. Z91.83 - ANSWER-A
In the ICD-10-CM Alphabetic Index look for Dementia/with behavioral disturbance. The
behavioral disturbance is the wandering. There is an instructional note under code
Z91.83 indicates to code first underlying disorder.
Patient presents to OB for routine obstetric care. The nurse takes the patient's blood
pressure and it reads 140/80. The physician sees the patient and documents the
following in the assessment and plan: "A/P: Hypertension, Transient, Check BP at home
Correct Answers
Which of the following medications are prescribed to cancer patients to eradicate the
cancer or for prophylaxis?
I. Tamoxifen
II. Anastrozole
III. Januvia
IV. Crestor
A. I and II
B. I and III
C. II and III
D. I, II, III and IV - ANSWER-A
Anastrozole is used to treat breast cancer in women who have gone through
menopause. It works by lowering estrogen hormone levels to help shrink tumors and
slow their growth. Tamoxifen is prescribed for women who have breast cancer with
tumors fueled by estrogen. The medication blocks the action of estrogen.
The definition of a best medical record for a RADV audit is:
A. Documentation validates the CMS requested HCCs, contains all the necessary
documentation elements and has an additional HCC not requested by CMS
B. Documentation that validates all the requested HCCs
C. Documentation that validates the requested HCC, but there is no provider signature
D. Documentation that validates the requested HCC plus validates an additional HCC,
contains all the necessary documentation elements, but is missing the provider
signature, for which a signed CMS attestation was provided but not signed by the
provider - ANSWER-A
RADV guidelines state that the Best Medical Record contains documentation that
supports HCC and all elements of proper documentation are followed, for example,
signed by provider. Proper documentation is the first aspect that must be reviewed to
determine if the record could be considered a Best Medical Record. After proper
documentation is determined, the additional HCC (which can decrease the amount
owed to CMS) within the note makes this the Best Medical Record.
Which of the following are reported by a provider for beneficiaries in a Medicare
Advantage Plan?
I. Nature of the presenting problem
II. Resolved conditions that have been treated in the past
III. Family history for all conditions
IV. All chronic conditions
A. I
, B. II and III
C. I and IV
D. I, II, III and IV - ANSWER-C
Providers must report all diagnoses that affect the patient's evaluation, care, and
treatment, including: Nature of the presenting problem All chronic conditions (such as
atrial fibrillation, congestive heart failure (CHF), chronic kidney disease (CKD),
rheumatoid arthritis, diabetes with manifestations, chronic obstruction pulmonary
disease (COPD), all active cancers) History on any relevant past conditions ZV-codes
(factors that influence health/status codes) E-codes (external causes of injury and
poisoning, and certain other consequences of external causes) HCC scores on
individual members determine CMS reimbursement to the plan. Diagnosis and
demographic information should be captured at each face-to-face encounter to obtain a
health-based measure of that member's future medical needs.
Which of the following records would be a good source for a retrospective chart audit?
A. DME documentation
B. Cardiologist records
C. Dietician notes
D. RN notes - ANSWER-B
A cardiologist is the only approved provider provided as an answer option according to
CMS for Risk Adjustment
Retrospective audits should include the following attributes:
I. Provider signatures
II. Supporting documentation of the patient's diagnoses
III. DOS
A. I
B. II
C. I and II
D. I, II and III - ANSWER-D
What is/are the correct code(s) for a nursing home patient with severe dementia often
caught wandering off from the floor?
A. F03.91, Z91.83
B. F02.81, Z91.83
C. F03.90, Z91.83
D. Z91.83 - ANSWER-A
In the ICD-10-CM Alphabetic Index look for Dementia/with behavioral disturbance. The
behavioral disturbance is the wandering. There is an instructional note under code
Z91.83 indicates to code first underlying disorder.
Patient presents to OB for routine obstetric care. The nurse takes the patient's blood
pressure and it reads 140/80. The physician sees the patient and documents the
following in the assessment and plan: "A/P: Hypertension, Transient, Check BP at home
